Literature search supported employment (I)Supported employment: what is it?PICO-question:P = patient people with mental illnessI = intervention supported employmentC = - - O = outcome effectiveness of supported employmentQuestion: Is supported employment effective for people with mental illness?

The effectiveness of supported employment for people with severe mental illness: a randomised controlled-trialIndividual Placement and support (IPS) is helping people with severe mental illness gain open employment. IPS is more effective than vocational services for every vocational outcome. Patients assigned to vocational services were significantly more likely to drop out of the service and to readmitted to hospital than were those assigned to IPS (drop out 45% - 13%).

A multi-site randomised controlled trial of evidence-based supported employment for adults with severe and persistent mental illnessThe results support previous international findings that IPS-supported employment is more effective than non-integrated supported employment. This results build on previous international findings of the greater effectiveness of IPS compared to alternative vocational services, and shows that IPS can be successfully hosted by mental health services.

What are the obstacles in supported employment?PICO-question:P = people with mental disabilitiesI = supported employmentC = -O = obstaclesQuestion: What are obstacles to work for people with mental disabilities?

The attitudes of clinicians may make it difficult to integrate vocational workers in clinical teams and hampers the development of referral systems. Clinicians and vocational workers may be protective of their patients and avoid rapid job placement for fear of placing too much stress on them. Also, the contextual differences may be important.

The IPS literature has tended to look at disincentives to employment for individuals and ignored those factors that reduce the likelihood of employers taking on workers with mental health problems, such as the level of tax on labour or regulations on job security.

Other barriers: integration of vocational and clinical services, lack of support and follow-up of patients by staff and lack of integration of workers into the clinical team.

Supported employment is an innovation with a strong evidence base, but it is subject to the same barriers as many other innovative schemes for its diffusion and its widespread adoption will require top-to-bottom changes to attitudes, structure and practice throughout our health and employment services.

Does it make sense to work with emotions?

‘This study provides preliminary support for the effectiveness of the Thinking Skills for Work Program at improving cognitive functioning and employment outcomes. Clients who participated in the program showed significantly greater improvements in several areas of cognitive functioning over the first 3 months of the study, as well as in the overall composite cognitive score.’

‘Finally, clients who participated in the Thinking Skills for Work Program had substantially higher rates of competitive work, including number of jobs, hours worked, and wages earned, suggesting that the program was successful at helping many clients achieve their goals of competitive employment. ’